The influence of attachment styles, dyadic processes and affective states on health outcomes of women with breast cancer and their identified significant other

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Restriction lift date:2021-01-23

Citation:Murphy, A. R. 2017. The influence of attachment styles, dyadic processes and affective states on health outcomes of women with breast cancer and their identified significant other. PhD Thesis, University College Cork.

Abstract:

Breast cancer is one of the most common diagnosed cancers in Ireland (National Cancer Registry Ireland (NCRI), 2014). In today’s healthcare system women with breast cancer are now more than ever being supported through their disease trajectory by the significant others in their lives. While significant others of women with breast cancer are increasingly being involved in their care, little research has been conducted that explores the relationship between women with breast cancer and their significant other. The rationale for this study was prompted by the current change within the Irish healthcare system whereby a transference of breast cancer services to outpatient settings and day procedures means that now more than ever significant others of women with breast cancer are involved in their care. Exploring this relationship is beneficial to healthcare professionals who care for these women as it can aid in further understanding the care needs of these individuals. This study aimed to examine the influence of attachment style, dyadic processes and affective states on quality of life for women with breast cancer and their identified significant other, using the principles of attachment theory (Bowlby, 1969) and underpinned by a framework devised by Pietromonaco, Uchino and Schetter, (2013). A cross sectional correlational survey design was used. Data were collected using a multi-scale questionnaire devised by the researcher, consisting of validated instruments which were administered to both the woman with breast cancer and her significant other. The questionnaire consisted of: questions assessing socio-demographics, The Relationship Questionnaire (RQ), The Berlin Social Support Scale, The Hospital Anxiety and Depression (HADS) Scale, The Relationship Satisfaction subscale and the Functional Assessment to Cancer Therapy scale (for use with both Breast Cancer and General Populations). Data were analysed using SPSS software 22.0. The Actor-Partner Interdependence Model (APIM) was used in analysing dyadic data. A convenience sample of women with breast cancer (n=147) and significant others (n=127) was recruited from a pre assessment and an outpatient clinic within a breast care centre, at a large urban hospital in the South of Ireland. A significant other was defined as the individual the woman identified as being most significant in their care, at the current time. Data from 114 dyad pairs (i.e. both the woman with breast cancer and her identified significant other) who completed the questionnaire, were extracted to form the dyad sample in the study. It was found that affective states relating to anxiety and depressive symptoms were strongly and negatively correlated with quality of life for both the women with breast cancer and their significant other (p≤0.001). Significant others were found to report poorer quality of life (M=77.3, SD=4.25) than women with breast cancer (M=88.6, SD=10.61). Furthermore, the dyadic data analysis identified that being a significant other of a woman with breast cancer was associated with a lower quality of life (p≤0.05). The study identified that the principles of attachment theory are applicable to the breast cancer context. The framework devised by Pietromonaco et al., (2013) was found to be applicable to this context, although adaptation was required. This research has provided substantial rationale for studying dyads in the breast cancer context as it has highlighted the impact that a breast cancer diagnosis has not only on the woman with breast cancer but on her significant other and their relationship. Thus, clinicians, practitioners and researchers need to be aware of the important role that dyadic relationships play in the care trajectory of the woman with a breast cancer diagnosis and their impact on the woman’s significant other.

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